Hypotensive patients with blunt abdominal trauma could skip the CT in the emergency department and go directly to exploratory laparotomy when they have positive focused abdominal sonography for trauma (FAST) findings, according to researchers from the University of California, Davis.
Hypotensive patients with blunt abdominal trauma could skip the CT in the emergency department and go directly to exploratory laparotomy when they have positive focused abdominal sonography for trauma (FAST) findings, according to researchers from the University of California, Davis.
Brett C. Lee and colleagues analyzed medical records of more than 4000 emergency room patients with blunt abdominal trauma over six years. They divided the patients into two groups - hypotensive and normotensive - and performed FAST on all 4029 patients. Of 122 hypotensive patients, 87 had positive findings on FAST, and 69 of them (79%) were taken directly to exploratory laparotomy and did not require CT to determine a need for the surgery.
FAST produced 85% sensitivity, 60% specificity, and overall 77% accuracy in predicting need for exploratory laparotomy.
The researchers compared these results with the 3907 blunt abdominal trauma patients who were normotensive on arrival. Only 323 patients in this group had positive FAST findings. FAST produced 85% sensitivity, 96% specificity, and overall accuracy of 96% in evaluating these patients for laparotomy.
Across the two populations, FAST had an overall accuracy of 95% in predicting need for laparotomy. The researchers concluded that positive FAST findings for hypotensive patients screened in the ER were sufficient to triage them directly to laparotomy without the need for CT.
The Reading Room: Racial and Ethnic Minorities, Cancer Screenings, and COVID-19
November 3rd 2020In this podcast episode, Dr. Shalom Kalnicki, from Montefiore and Albert Einstein College of Medicine, discusses the disparities minority patients face with cancer screenings and what can be done to increase access during the pandemic.
Study Finds Transvaginal Ultrasound Unreliable for Detecting Endometrial Cancer in Black Patients
July 3rd 2024Utilizing a threshold of less than 5 mm of ultrasound-measured endometrial thickness, the authors of a new study noted an 11.4 percent false-negative probability for endometrial cancer in Black patients.
New Study Shows Non-Radiologists Interpreting 28 Percent of Imaging for Medicare Patients
June 28th 2024While radiologists interpreted approximately 99 percent of all non-cardiac CT, MRI and nuclear medicine studies in hospital and emergency department settings for Medicare beneficiaries, new research shows significantly less radiologist review of cardiac imaging and office-based imaging.
FDA Clears Pocket-Sized ECG System and AI Technology for Detection of Cardiac Conditions
June 27th 2024Using a reduced leadset and deep neural network algorithms trained on more than 175 million electrocardiograms, the KAI 12L technology reportedly detects up to 35 cardiac determinations, including acute myocardial infarction.